Chronic hepatitis C. Genotypes and response to anti-viral therapy among Saudi patients

The aim of this study is to compare the response of hepatitis C virus [HCV] genotype 4 with other genotypes to anti-viral treatment among Saudi patients in a prospective randomized trial. The study was conducted in the Department of Hepatobiliary Sciences at King Abdul-Aziz Medical City, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia from March 1997 to January 2000. Sixty-two patients [33 males and 29 females] aged >/= 18 with chronic hepatitis C not treated previously were tested for HCV genotype and randomly assigned to receive interferon [IFN] alfa 2b 3 million units 3 times per week alone or in combination with ribavirin 1000-1200mg orally per day for 48 weeks. All patients were monitored for safety and efficacy of the therapy at 4 week intervals during treatment and followed up for at least 24 weeks after completion of treatment. The primary end point was loss of detectable HCV-RNA 24 weeks after treatment completion, defined as sustained virological response [SVR]. Hepatitis C virus genotype 4 was seen among [64.5%] HCV Saudi patients. Hepatitis C virus genotype 1 was the next most common [30.6%]. A SVR of 42.8% [9 out of 21] was seen in HCV genotype 4 and 40% [4 out of 10] among other HCV genotypes with combination therapy of IFN and ribavirin [p>0.1]. With IFN alone the sustained response rate was 15.7% for genotype 4 and 16.6% for other genotypes mainly genotype 1 [p>0.1]. We concluded that HCV genotype 4 is the most prevalent genotype among HCV infected Saudi patients. Genotype 1 was the next most common while genotypes 2, 3 and 5 were least prevalent. There is no statistically significant difference in response rate of patients with HCV genotype 4 to either IFN alone or IFN plus ribavirin when compared with genotype 1 of HCV

Prevalence of hepatitis delta antibody among HBsAG carriers in Saudi Arabia

Background: There are a paucity of data available on the exact prevalence of delta hepatitis among HBsAg positive carriers in Saudi Arabia. The aim of this study was to determine the exact prevalence of delta antibody in HBsAg positive carriers in Saudi Arabia

Patients and Methods: Between January 1996 and January 1997 the serum of 19,250 patients was tested for HBsAg. HBsAg positive sera were subsequently tested for delta antibody. In addition, 3147 healthy blood donors underwent HBsAg testing. Those who were HBsAg positive had delta antibody testing using the ELISA method

Results: Among 19,250 patients, 780 [4.1%] were HBsAg positive, of which 67 [8.6%] patients were anti-delta positive and 2 [0.25%] were anti-delta borderline. Among 3147 healthy donors, 60 [1.9%] were HBsAg positive with 2 [3.3%] being delta antibody positive

Conclusion: The prevalence of delta antibody among hospital- and clinic-based HBsAg positive patients was 8.6% and among healthy blood donors who were HBsAg positive, the prevalence was 3.3%. Furthermore, delta antibody prevalence was 0.06% for [all comers], i.e., healthy blood donors. With decreasing hepatitis B prevalence as a result of universal vaccination, it is expected that delta hepatitis infection among Saudis will decrease with time